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Review
. 2024 Jul;13(7):1399-1417.
doi: 10.1007/s40121-024-00974-7. Epub 2024 May 6.

Respiratory Syncytial Virus Sequelae Among Adults in High-Income Countries: A Systematic Literature Review and Meta-analysis

Egbe Ubamadu  1 , Estefania Betancur  1 , Bradford D Gessner  2   3 , Sonia Menon  1 , Hilde Vroling  1 , Daniel Curcio  2   3 , Mark Rozenbaum  4 , Samantha K Kurosky  5 , Zuleika Aponte  1 , Elizabeth Begier  6   7
Affiliations
Review

Respiratory Syncytial Virus Sequelae Among Adults in High-Income Countries: A Systematic Literature Review and Meta-analysis

Egbe Ubamadu et al. Infect Dis Ther. 2024 Jul.

Abstract

Introduction: Respiratory syncytial virus (RSV) can cause severe respiratory infections in adults; however, information on associated sequelae is limited. This systematic literature review aimed to identify sequelae in adults within 1 year following RSV-related hospitalization or resolution of acute infection.

Methods: Studies were identified from Embase, MEDLINE, LILACS, SciELO, and grey literature. Random-effects meta-analyses using restricted maximum likelihood were used to calculate the proportions and relative risks of sequelae in patients with RSV compared with controls (patients with RSV-negative influenza-like illness, influenza, and parainfluenza) per follow-up period, population, and treatment setting, where possible.

Results: Twenty-one relevant studies covering the period from 1990 to 2019 were included. Among the general population, the most frequent clinical sequela was sustained function loss (33.5% [95% CI 27.6-39.9]). Decline in lung function and cardiovascular event or congestive heart failure were also identified. Utilization sequelae were readmission (highest at > 6 months after discharge) and placement in a skilled nursing facility. The only subpopulation with data regarding sequelae was transplant patients. Among lung transplant patients, the most frequently reported clinical sequelae were decline in lung function, followed by graft dysfunction and bronchiolitis obliterans syndrome. Pooled relative risks were calculated for the following sequela with controls (primarily influenza-positive patients): cardiovascular event (general population) and pulmonary impairment (hematogenic-transplant patients) both 1.4 (95% CI 1.0-2.0) and for readmission (general population) 1.2 (95% CI 1.1-1.3).

Conclusions: Although less data are available for RSV than for influenza or other lower respiratory tract infections, RSV infection among adults is associated with medically important sequelae, with a prevalence similar to other respiratory pathogens. RSV sequelae should be included in disease burden estimates.

Keywords: Adults; RSV; Respiratory syncytial virus; Sequelae; Systematic review.

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Conflict of interest statement

Bradford D. Gessner, Daniel Curcio, Mark Rozenbaum, Samantha K. Kurosky, and Elizabeth Begier are employees of Pfizer and may own Pfizer stock. Egbe Ubamadu, Estefania Betancur, Sonia Menon, Hilde Vroling, and Zuleika Aponte are employees of P95, which was a paid contractor to Pfizer in connection with the development of this manuscript. Sonia Menon affiliated with Epitech Research was an employee of P95 at the time this research was performed.

Figures

Fig. 1
Fig. 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram
Fig. 2
Fig. 2
Proportions of RSV-associated cardiovascular events and function loss by a follow-up period and b treatment setting
Fig. 3
Fig. 3
Proportions of RSV-associated bronchiolitis obliterans syndrome by a follow-up period and b treatment setting
Fig. 4
Fig. 4
Relative risks of RSV-associated a readmission, b cardiovascular events, and c pulmonary impairment by follow-up period
See this image and copyright information in PMC

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